| NPI | 1568835007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA5554) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 006692) |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2026-07-24 |